Biliary tract and upper gastrointestinal system; CH 14
esophogram
(Barium swallow) a radiographic examination specifically of the pharynx and esophagus. It studies the form and function of the swallowing aspect of the pharynx and esophagus
biliary calculi
(Gallstones)
submandibular salivary glands
(Submaxillary) under the mandible or maxilla
upper gastrointestinal series
(UGI) (upper gi) a procedure designed to study the distal esophagus, stomach, and duodenum
esophagogastric junction
(cardiac orifice) The opening between the esophagus and stomach
Three parts of the pharynx
1- Naso 2- Oro 3- Laryngeal/hypo
What are the 3 primary functions of the digestive system
1- the intake and/or digestion of food' water, vitamins, and minerals 2- absorb digested food particles along with water, vitamins and essential elements from the alimentary canal, into the blood or lymphatic capillaries 3- eliminate any unused material in the form of semisolid waste products
The liver performs more than ______ different functions
100
How much is secreted by the delivery glands daily
1000-1500 mL
How much does the liver weigh?
3 or 4 pounds, or 1/36 of the total body weight in an average adult
Cystic duct
3-4 cm long and contains several membranous folds along its length called spiral valves
How much bile does the gallbladder usually hold?
30-40 mL
What percent of individuals have separated common bile ducts and pancreatic ducts?
40%
How many lobes does the liver have?
4; 2 major and 2 minor only the 2 major are seen
What percentage of individuals have joined common bile and pancreatic ducts?
60%
How many percent of patients who have a gallbladder carcinoma also has stones
80%
How much bile does the liver secrete per day?
800-100 mL, or about 1 quart, of bile per day
Saliva is ___% water and ___% solutes or salts and certain digestive enzymes
99.5% 0.5%
What is the gallbladder shaped as?
A pear
What abdominal ragion does the liver occupy?
Almost all of the right hypochondrium, a major part of the epigastrium, and a significant part of the left hypchondrium
When the common bile and pancreatic ducts are joined what is it called?
Ampulla,. hepatopancreatic ampulla, or ampulla of Vater
what enzyme does saliva contain and what does it do?
Amylase, begins the digestion of starches
What separates the body of the stomach from the pyloric portion of the stomach
Angular notch (incisura angularis)
what is the preferred contrast medium for the entire alimentary canal?
Barium sulfate mixed with water; shows up white on the radiograph
Sublingual salivary glands
Below the tongue
Chole
Bile
food is ingested in the form of:
Carbohydrates, lipids, and proteins
The large right lobe is seperated from the smaller left lobe by the what?
Falciform ligament
Spiral valves
Function to prevent distention or collapse of the cystic duct
Bile is concentrated within the gallbladder as a result of what?
Hydrolysis (removal of water)
what leads to the formation of gallstones?
Increased levels of bilirubin, calcium, or cholesterole
What contours over the surface of the caudate lobe?
Inferior vena cava (IVC)
How long is the common bile duct?
It averages about 7.5 cm in length and has the internal diameter about the size of a drinking straw
Quadrate lobe
Located on the inferior surface of the right lobe between the gallbladder and falciform ligament.
what part of the pharynx is not part of the digestive system
Nasopharynx
What are the advantages to using sonography?
No ionizing radiation, detection of small calculi, no contrast medium, less patient preparation
Greater curvature
On the lateral border of the stomach, 4 to 5 times longer than the lesser, forms a concave border
lesser curvature
On the medial border of the stomach, forms a concave border
What is the lowest border of the kidney?
On the right side (lateral) to the tenth rib just above the right kidney
Where are the 2 minor lobes located?
Posterior to the right lobe of the kidney
What position would place the gallbladder closest to the IR?
Prone
2 parts of the pyloric portion of the stomach
Pyloric antrum, and pyloric canal
The opening or orifice as it leaves the distal stomach is termed the:
Pyloric orifice or pylorus. It is a thickened muscular ring that relaxes periodically during digestion to allow stomach or gastric contents to move into the first part of the small intestine.
What quadrant does the liver occupy?
RUQ
What are the accessory organs of the digestive system
Salivary glands, pancreas, liver, and gallbladder.
During swallowing, the ______ ______ closes off the nasopharynx to prevent swallowed substances from regurgitating into the nose, and the _________ prevents this material from reentering the mouth
Soft palate; mouth
what has replaced oral cholecystography?
Sonography
Hepatopancreatic ampulla
Sphincter of Oddi, located near the teminal opening of the hepatopancreatic ampulla into the duodenum. They are circular muscle fibers. They relax when CCK increases in the bloodstream. It causes a protrusion into the lumen of the duodenum (Duodenal papilla (papilla of vater)
What position would best drain the gallbladder into the duct system
Supine
What is the main section of the gallbladder?
The body
The fundus of the gallbladder
The distal end and the broadest part of the gallbladder
Milk calcium bile
The emulsion of biliary stones in the gallbladder
parotid salivary glandS
The largest located beneath and just anterior to the external ear canal
The neck of the gallbladder
The narrow proximal end that continues as the cystic duct
What is also known as the duct of Wirsung
The pancreatic duct
What border of the liver is its greatest verticle dimension?
The right (lateral), 6-7 inches
What is the function of bile?
To aid in the digestion of fats by emulsifying or breaking down fat gobules and the absorption of fat following its digestion
What are the 3 primary functions of the gallbladder?
To store bile, concentrate bile, and contract when stimulated
True or False: Bile also contains cholesterol, which is made soluble in the bile by bile salts
True
True or False: CCK causes the gallbladder to contract, and causes increased exocrine activivty by the pancreas
True
True or False: The common bile duct descends behind the superior portion of the duodenum and the head of the pancreas to enter the second or descending portion of the duodenum
True
True or False: The normal gallbladder is from 7 to 10 cm long and about 3 cm wide.
True
True or false: specific salivary glands secrete a thickened fluid that contains mucus. This lubricates food that's being chewed so that the food can form into a ball, or bolus, for swallowing
True
What border of the liver is the widest?
Upper border; about 8-9 inches
What causes the gallbladder to contract?
When foods such as fats or fatty acids are in the duodenum. The foods stimulate the duodenal mucosa to secrete the hormone cholecystokinin (CCK). Increased levels of CCK in the blood cause the gallbladder to contract and the terminal opening of the common bile duct to relax.
How are gallstones formed?
When too much water is absorbed or if the cholesterol becomes to concentrated
cardiac spincter
a small circular muscle, allows food and fluid to pass through the cardiac orifice (esophagogastric junction)
bacterial infection and ischemia (obstruction of blood supply) may also produce _________ cholecystitis?
acute
Chronic cholecystitis
almost always associated with gallstones but may also be an outcome of pancreatitis or carcinoma of the gallbladder.
mumps
an inflammation and enlargement of the parotid glands caused by the mumps virus. ( for about 30% of males past puberty there is also an inflammation of the testes)
The distal end of the gallbladder extends slightly below the _______, _________ margin of the liver and the rest lies along the _______ and _______ surface of the liver
anterior, inferior inferior and posterior
mastication
chewing, the mechanical part of digestion
What forms the most common type of gallstones?
cholesterol coming out of solution
hepatopancreatic sphincter (Sphincter of oddi)
circular muscle fiber near the terminal opening of the heaptopancreatic ampulla. It relaxes when CCK levels increase
cholelithiasis
condition of having gall stones
Function of saliva
dissolve foods so digestion can begin
During swallowing, the ________ is depressed to cover the laryngeal opening like a lid. The _____ ____ also come together to close off the epiglottis
epiglottis, focal folds/cords
what is the narrowest part of the alimentary canal
esophagus
Duodenal papilla (papilla of vater)
formed by hepatopancreatic sphincter. Its a protrusion into the lumen of the duodenum
Gastric canal
formed by rugae along the lesser curvature, funnels fluids directly from the body of the stomach to the pylorus
three main subdivisions of the stomach
fundus, body, and the pylorus
choleliths
gallstones
What may lead to a gangrenous gallbladder
gas producing bacteria
Oral Cholecystogram
in the past contrast was ingested orally to view the gallbladder.
cholecystitis
inflammation of the gallbladder
Caudate lobe
located posterior to the quadrate lobe, it extends superiorly to the diaphragmatic surface
Biliary stenosis
narrowing of one of the biliary ducts. May result in cholecystitis and jaundice
clinical indications for oral cholecystogram
nausea, heartburn, and vomiting
acute cholecystitis
often a blockage of the cystic duct restricts the flow of bile from the gallbladder into the common bile duct. The blockage is usually at the neck of the gallbladder.
list the organs of the alimentary canal
oral cavity (mouth), pharynx, esophagus, stomach, small intestine, large intestine, and anus
choledocholithiasis
presence of stones in the biliary duct
Cholangiogram
radiographic examination of the biliary ducts
cysto
sac or bladder
cholecystocholangiogram
study of the gallbladder and the biliary ducts
cholecystectomy
surgical removal of the gallbladder
Deglutition
the act of swallowing
Where is bile stored
the gallbladder
What is the largest organ in the human body?
the liver
Where is bile manufactured?
the liver
True or false: the gallbladder is anterior to the midcoronal plane and the duct system is about midway between the front and the back.
true